Entry Level Aetna Insurance Jobs (NOW HIRING)

Claim Specialist

Mindful Therapy Group is a company dedicated to empowering therapists, psychologists, and nurse practitioners to dive into private practice, without doing all of the leg work that comes with it. We provide high-quality billing, marketing, and administrative services to independent mental health care providers. Since opening in 2011, we have partnered with over 2,300 providers throughout our 25+ locations, and we are continuing to grow!

We are seeking an experienced claim specialist to independently resolve complex outstanding insurance balances, denials, and claim-processing issues across commercial, Medicare, and Medicaid payers.

This is not an entry-level billing or payment-posting role. The ideal candidate has at least two years of hands-on insurance A/R follow-up and claim-resolution experience, including direct payer outreach, portal-based research, denial management, corrected claims, reconsiderations, appeals, and escalation of recurring payer or workflow issues. They are comfortable taking ownership of a claim from initial denial or nonpayment through final resolution.

We are especially interested in candidates with substantial experience working Washington Medicaid claims, eligibility, authorization-related denials, managed-care plans, and state-specific billing or reimbursement requirements.

Responsibilities include:

• Independently work outstanding insurance A/R, with a focus on denied, rejected, and aged claims, including balances aged 120+ days.
• Analyze denial reason codes, payer correspondence, eligibility and benefits information, authorization requirements, coding or claim-edit issues, and filing-limit concerns to determine the appropriate next action.
• Submit and track corrected claims, reprocessed claims, reconsiderations, appeals, medical-record submissions, and other payer-required documentation.
• Navigate commercial payer portals and communicate directly with payer representatives to obtain claim status, denial details, payment information, and resolution commitments.
• Communicate claim status, documentation needs, and action items to providers and internal partners in a clear, professional, solutions-focused manner.
• Post insurance payments and adjustments accurately when assigned, including ensuring payment activity aligns with remittance advice and claim-resolution outcomes.
• Maintain thorough, actionable documentation in the EHR (AdvancedMD) and related tracking tools so other team members can easily understand the claim history and next steps.

Qualifications:

• At least 2 years of direct medical insurance A/R follow-up and claim-resolution experience in a healthcare billing environment.
• Hands-on experience working commercial insurance, Medicare, Medicaid, and managed Medicaid claims.
• Strong written and verbal communication skills, with the ability to communicate professionally and effectively with payer representatives, providers, managers, and internal teams.
• Experience working in an EHR or practice-management system, payer portals, clearinghouse tools, Microsoft Excel, and Outlook.
• Strong attention to detail, organization, follow-through, and documentation habits.

Preferred Qualifications:

• Experience resolving Washington Medicaid denials involving eligibility, managed-care enrollment, authorizations, provider enrollment, billing requirements, reimbursement, or claim-processing rules.
• Behavioral health billing and insurance A/R experience.
• Experience with AdvancedMD or a similar behavioral health EHR/practice-management platform.
• Experience with payer portals for regional and national commercial payers, including Blue Cross Blue Shield plans, Aetna, Cigna, Optum/UnitedHealthcare, Medicare contractors, and Medicaid managed-care organizations.
• Experience working with Apple computers and macOS.

We provide our full-time employees with:

• 75% coverage of health, dental, and vision insurance
• 15 PTO days accrued annually in first year
• 6 paid holidays per year
• 401k matching
• Life Insurance
• Professional development training and opportunities for advancement

We are an equal opportunity employer with a progressive workplace based on teamwork, integrity, and customer service. We are committed to cultivating the long-term professional potential of our team. Applicants from all fields are encouraged to apply. Background check required. Come join a strong team making an impact in the service world of mental health!

It is a conflict of interest for an employee of Mindful Support Services to be a current client of Mindful Therapy Group. We request that individuals who are receiving clinical services at Mindful Therapy Group wait until their care is discontinued before beginning employment.

Job Type: This position is fully in-office at our Northgate headquarters.

Monday-Friday, 8:30am-5:00pm

Salary: $24-$28/ hourly depending on experience